Contributing Factors to Heterogeneity in the Timing of the Onset of Nonfatal Suicidal Behavior: Results From a Nationally Representative Study
Abstract : BACKGROUND:
It remains unclear whether specific clinical factors contribute to
heterogeneity in the timing of the onset of nonfatal suicidal behavior.
This knowledge could have important implications for suicide prevention.
METHODS:
Using a nationally representative US adult sample, the second wave of
the National Epidemiologic Survey on Alcohol and Related Conditions
(2004-2005; n = 34,629), we compared the characteristics of 4 different
suicide attempter groups: those who first attempted (1) before 18 years,
(2) from 18 to 34 years, (3) from 35 to 49 years, and (4) at 50 years
or older. Specifically, DSM-IV psychiatric disorders that occurred
before the first suicide attempt, childhood maltreatment experiences,
parental history of psychiatric disorders, and sociodemographic
characteristics were examined.
RESULTS:
Most first nonfatal suicide attempts (85.3%) occurred before age 35
years. Compared with suicide attempts occurring from 18 to 34 years,
suicide attempts occurring before 18 years were more strongly associated
with childhood maltreatment and less strongly linked to lifetime prior
psychiatric disorders, whereas first suicide attempts occurring at 35
years and older were more strongly associated with a prior lifetime
history of substance use disorders, including alcohol use disorder and
nicotine dependence, and mood disorders, including mania/hypomania and
dysthymic disorder between 35 and 49 years and major depressive episode
at 50 years and older (all P < .05).
CONCLUSIONS:
These results suggest age differences in risk factors for first nonfatal
suicide attempt. Improving early detection and treatment of psychiatric
disorders and preventing childhood maltreatment may have broad benefits
to reduce the burden of suicidal behavior at all ages.